This proposal from the Johns Hopkins University requests five years of funding for a center to study services and systems of services for children and adolescents with severe emotional disturbances (SED) or at high risk for SED. The proposed Center is built upon strong multidisciplinary linkages across the major academic institutions in Baltimore, the major state and local public agencies serving children and adolescents, private service providers, advocates, parents and family members. Academic researchers include faculty from the Departments of Mental Hygiene, Health Policy and Management, Maternal and Child Health, and Biostatistics of the Johns Hopkins University (JHU) School of Hygiene and Public Health; the Departments of Psychiatry and Pediatrics of the JHU School of Medicine; the Center on the Social Organization of Schools of JHU, the Department of Psychiatry of the University of Maryland (UM) School of Medicine, and the Schools of Law of the UM. The goal of the Center is to conduct policy relevant research that will (1) expand knowledge of service systems and factors related to effectiveness and cost and (2) promote and evaluate potential improvements in the delivery of services to youth with SED or at high risk for SED. During the next five years the Center will undertake the following: 1. Method Development: Develop, implement, and test methods that integrate observational, epidemiologic, economic, and organizational approaches for studying need, alternative organizational and financial arrangements, outcomes and costs; 2. Individual Characteristics: Examine the characteristics of youth with SED (and their families) having contact with providers of health and social services and other public agencies and the relationships of these characteristics to patterns of care; 3. System Characteristics: Assess alternatives for financing and organization of services at the state and local level; 4. Outcomes: Conduct outcome and cost-effectiveness studies to identify clinical, demographic, treatment, family, organizational, and economic factors related to outcomes and costs of services; and, 5. Dissemination: Disseminate policy relevant and methodologic findings to other researchers, policy makers, system administrators, insurers and payers, providers, and family members.